Provider Demographics
NPI:1952169070
Name:OWEN, DELISSA KRISTINA
Entity Type:Individual
Prefix:MRS
First Name:DELISSA
Middle Name:KRISTINA
Last Name:OWEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:384 W RIVERVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7829
Mailing Address - Country:US
Mailing Address - Phone:907-420-4932
Mailing Address - Fax:
Practice Address - Street 1:384 W RIVERVIEW AVE
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-7829
Practice Address - Country:US
Practice Address - Phone:907-420-4932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula